心房颤动合并高血压患者卒中危险因素分析  

An analysis of risk factors for stroke in atrial fibrillation and hypertension patients

作　　者：王娟[1,2] 杨艳敏[1,2] 朱俊[1,2] 邵兴慧[1,2] 张晗[1,2] 李建冬[1,2] 刘力生[1,2] 

机构地区：[1]北京协和医学院中国医学科学院阜外心血管病医院心内科急重症中心国家心血管病中心心血管疾病国家重点实验室,100037 [2]中国急诊心房颤动注册研究协作组

出　　处：《中华内科杂志》2014年第4期269-272,共4页Chinese Journal of Internal Medicine

摘　　要：目的 探讨心房颤动（房颤）合并高血压患者1年随访的卒中发生率及其危险因素.方法 分析中国急诊房颤注册研究（20家医院）的房颤合并高血压患者资料,根据1年随访事件中是否发生卒中将患者分为卒中组和非卒中组.用单因素和多因素Cox回归模型分析影响房颤合并高血压患者1年卒中发生的独立危险因素.结果 共入选1 118例房颤合并高血压患者,其中卒中组97例,非卒中组1 021例,1年卒中发生率为8.7％.卒中组年龄显著高于非卒中组[（76.0±9.4）岁比（71.9±10.6）岁,P＜0.01],卒中组女性、既往卒中史所占比例高于非卒中组（68.0％比54.5％,38.1％比23.8％,P值均＜0.05）.非卒中组接受抗高血压治疗比例高于卒中组（91.6％比85.6％,P＜0.05）.卒中组患者他汀类药物的应用比例高于非卒中组（45.4％比34.5％,P＜0.05）.多因素Cox回归模型分析显示,年龄（HR=1.036,95％CI1.010 ～1.062）、女性（HR=1.908,95％CI1.170～3.110）、未接受抗高血压治疗（HR=1.955,95％ CI1.008 ～ 3.791）、既往卒中史（HR=1.680,95％CI1.084 ～2.603）是房颤合并高血压患者1年卒中发生的独立危险因素.结论 年龄、女性、未接受抗高血压治疗和既往卒中史是房颤合并高血压患者1年卒中发生的独立危险因素.Objective To explore the independent risk factors for the 1 year stroke event in Chinese patients with atrial fibrillation （AF） and hypertension （HT）.Methods Data of AF and HT patients in the Chinese Emergency Atrial Fibrillation Registry Study were retrospectively analyzed.The eligible patients were divided into the stroke group and the non-stroke group according to the result of 1 year follow-up.The predictors for the 1 year stroke event were identified by uni-and multi-variate Cox regression analysis with the baseline and therapeutic variables.Results A total of 1 118 AF and HT patients were enrolled in the study with the incidence of 1 year stroke event of 8.7%.All patients were divided into the stroke group （n =97） and the non-stroke group （n =1 021）.Compared with the non-stroke group,more female patients were in the stroke group （68.0% vs 54.5%,P 〈 0.05） and the patients in the stroke group were older [（76.0 ± 9.4） years vs （71.9 ± 10.6） years,P 〈 0.01] with higher proportion of previous history of stroke （38.1% vs 23.8%,P 〈0.01）.More patients were observed on the antihypertensive treatment in the non-stroke group （91.6% vs 85.6%,P 〈 0.05）,while more patients on statins in the stroke group（45.4%vs 34.5%,P 〈 0.05）.Multi-variate Cox regression analysis showed that age （HR =1.036,95% CI 1.010-1.062）,female （HR =1.908,95% CI 1.170-3.110）,previous stroke history （HR =1.680,95% CI 1.084-2.603）,and no antihypertensive treatment （HR =1.955,95% CI 1.008-3.791） were independent risk factors for the 1 year stroke event in patients with AF and HT.Conclusion Age,female,previous stroke history and no antihypertensive treatment are the independent risk factors for the 1 year stroke event in patients with AF and HT.

关 键 词：心房颤动 高血压 脑血管意外 危险因素 

分 类 号：R541.7[医药卫生—心血管疾病] R743.3[医药卫生—内科学]